Provider Demographics
NPI:1871371393
Name:ZUNIGA PENET, JOSE ABRAHAN (SA-C)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:ABRAHAN
Last Name:ZUNIGA PENET
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3435 NW 1ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-4932
Mailing Address - Country:US
Mailing Address - Phone:786-535-5811
Mailing Address - Fax:
Practice Address - Street 1:3435 NW 1ST ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-4932
Practice Address - Country:US
Practice Address - Phone:786-535-5811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23-621246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant